Child Health info

Wee Care Child Care Of Massena, Inc. | home

Child Health info

CHICKEN POX

Patient Information

What is Chicken Pox?

Chicken pox is a highly contagious viral disease that is spread by direct contact or breathing in germs from someone's cough or sneeze. Two weeks after exposure, chicken pox spots appear on the body.

What are the signs and symptoms?

The following symptoms will occur 10-21 days after exposure to chicken pox:

1.Low grade fever.

2.Runny nose, slight cough.

3.Decrease in appetite.

4.Headache.

5.Tired, rundown feeling.

These symptoms usually occur 24-48 hours before the spots appear on the body.

When the spots first appear they will start on the chest, back, or face, and eventually are seen over the entire body. The spots may occur in the mouth as white ulcers, and as ulcers in the ears and eyes.

How is Chicken Pox treated?

1.Baking soda bath.

2.Calamine lotion as needed to skin.

3.Benadryl liquid or capsules taken by mouth for itching.

4.Acetaminophen (Tylenol) for fever above 102 degrees = No Aspirin!!!!

5.For sores in mouth, rinse with warm water - hydrogen peroxide mouth rinses.

Keep the sores clean by bathing daily. If the sores look infected, wash them well and apply Neosporin or Bacitracin ointment 4 times a day.

What else do I need to know about Chicken Pox?

1.Chicken pox is spread by direct contact or breathing in from nose and throat secretions.

2.Crusts do not contain the virus.

3.Crusting occurs in 5 to 10 days after breakout.

4.Children are not to go to school for at least 7 days - until all sores are crusted.

5.Trim nails and do not scratch.

6.Bathe daily.

7.Let scabs fall off by themselves.

8.Call if your symptoms are persistent.

Asthma

Asthma affects more than 10 million Americans and is one of the leading causes of school and work absences. Over one billion dollars is spent each year on health care for asthma. Although its exact cause remains a mystery and no cure exists, many excellent treatment options are available to control and reverse this chronic obstruction of the airways.

What is asthma?

Asthma is a respiratory condition characterized by episodes of airflow obstruction in the bronchial tubes. Symptoms caused by this obstruction include coughing, chest tightness, wheezing and shortness of breath. Although problems are often separated by symptom-free periods, asthma is a chronic illness.

Who gets asthma?

Asthma tends to occur within families. The role of inheritance plays a less clearer role in adult-onset asthma. People of any age may suffer from asthma, but more than half the cases are found in children between the ages of 2 and 17. In young children, boys are nearly twice as likely to develop asthma as girls, but this sex difference tends to disappear in older age groups.

What causes an asthma attack?

A wide variety of "triggers" may initiate an episode of asthma. The most common triggers are allergens, aspirin and tartrazine, irritants, food additives and preservatives, viral respiratory infections and physical exertion.

Allergens are substances to which susceptible individuals may become allergic. They are a major source of problems in children and adults. Common allergens include plant pollen (tree, grass and weed), animal dander, housedust mites, molds and certain foods. When an allergic individual comes in contact with one of these allergens, a complicated series of events causes the body to release certain chemicals (mediators). These mediators then trigger asthma.

Aspirin and aspirin-containing products can trigger asthma attacks in susceptible individuals. The exact cause of the reaction is unclear, but it does not appear to be an allergic reaction. Ten to twenty percent of asthmatics experience a significant decrease in their lung function after taking aspirin. Similar reactions can occur with a related group of medications called nonsteroidal anti-inflammatory agents and with tartrazine (yellow food dye #5). As a general rule, asthmatics should avoid these products.

Cold air, smoke, industrial chemicals, perfume, paint and gasoline fumes are all examples of irritants that can provoke asthma. These irritants probably trigger asthma by stimulating irritant receptors in the respiratory tract. These receptors, in turn, cause the muscles surrounding the airway to constrict, resulting in an asthma attack.

Although food additives can trigger asthma, this is rare. The most common trigger is sulfites, which are used to preserve certain foods and medications. Viral respiratory infections are the leading cause of acute asthma attacks. Surprisingly, bacterial infections (except sinusitis) do not usually provoke acute asthma attacks.

What happens during an asthma attack?

An asthmatic's breathing tubes are "twitchy." That is, an asthmatic's bronchial tubes narrow in response to certain triggers. Because individuals without asthma do not react to these stimuli, an asthmatic's bronchi are described as hyperactive. During and attack, muscles surrounding the bronchial tubes contract, narrowing the air passages. Inflammation also occurs along the lining of the airways which produces swelling and further reduction of airway size. In addition, mucus glands along the inside of the air passages produce excess mucus which accumulates in the already narrowed air passages. The end result is that breathing, especially exhaling, becomes extremely difficult. Air becomes trapped behind the narrowed bronchial passages and there is a decrease in the oxygen available to the body.

How long does an asthma attack last?

The duration varies according to the severity of the attack. Mild episodes may only last a few hours. Severe episodes, however, may go on for days or even weeks. Mild attacks can resolve spontaneously or may require medication. More severe attacks can also be treated with medications but may require hospitalization.

What should be done during an attack?

Always follow the instructions of your allergist. In general, it is important to stay calm and take your prescribed medications. Bronchodilators are the most commonly prescribed drugs to treat asthma. They relax the muscles surrounding the airways, resulting in dilation of the bronchial tubes. Bronchodilators may be inhaled, taken orally or injected.

Why does physical exertion cause an attack?

During exercise, rapid breathing occurs through the mouth. As a result, the air which reaches the bronchial tubes has not been warmed and humidified by passing through the nose. This cold, dry air can trigger asthma. Asthma symptoms are generally at their worst after six to eight minutes of aerobic exercise. Over 70% of all asthmatics suffer some degree of exercise-induced asthma.

Should asthmatics avoid sports and exercise?

By taking preventive measures, asthmatics should be able to compete in any sport. Not all sports, however, are equally tolerated. In general, exercise and sports that involve prolonged periods of running are more likely to provoke asthma attacks than nonaerobic ones. Swimming is one of the best tolerated sports. In most instances, exercise induced asthma can be controlled to allow participation in any sport. Many Olympic athletes, including several gold medal winners, have had asthma.

What is the difference between allergies and asthma?

Asthma is obstruction of airflow in the bronchial tubes that is reversible. Allergies are one of the factors that can trigger asthma attacks. Not all asthmatics are allergic and there are many people who are allergic but do not have asthma.

Is there a cure for asthma?

Though it has long been treatable, a cure for asthma remains elusive. Preventive treatment, however, may minimize the difficulty an individual experiences with asthma.

What's the best treatment?

Prevention is always the best form of treatment. It is important for an asthmatic to learn what conditions prompt an attack and avoid them whenever possible. When avoidance is impossible, preventive treatment is desirable. Various forms of preventive therapy are available.

Medications may be started prior to exercise or exposure to environments that predictably produce an attack.

If the asthma attacks are frequent or unpredictable, your allergist may advise you to take medications on a routine basis. Drugs used for this purpose include long-acting theophyllines, inhaled or oral beta agonists, cromolyn and inhaled or oral steroids. For allergic asthmatics, immunotherapy (allergy shots) may offer relief from allergens that cannot be avoided. Immunotherapy increases a patient's tolerance to the allergens that prompt asthma symptoms.

Is asthma a psychological disorder?

No, but emotions can worsen asthma. Panic can prevent an asthmatic from relaxing and following instructions properly, both of which are essential during an attack. Also, scientists have found that strong emotions can cause an asthmatic's bronchial tubes to constrict, which may provoke or worsen an attack.

Asthma can cause emotional strain. Depression often sets in when asthmatics cannot participate in normal activities. Asthma is a leading cause of school absences, which can have far reaching effects on the child's emotional well-being and education. Finally, it must also be remembered that asthma can be a major emotional and financial strain on the entire family.

Will some children outgrow asthma?

The idea that asthma will be outgrown is more a myth than reality. True, some individuals may reach a point where they no longer suffer asthmatic symptoms as they did in earlier years. But sophisticated testing would show these individuals still run the risk of attacks later in life.

Is asthma life-threatening?

In severe cases, asthma can be life threatening. Deaths occur more frequently in adults. More than 80% of the 3,880 deaths related to asthma in 1985 occurred in asthmatics over age 45. Usually, however, the airways can be opened and the attack controlled with medications. In a severe attack, the airways may become completely blocked leading to respiratory failure. This condition is a medical emergency and requires immediate attention. It is important for asthmatics to learn to recognize severe episodes and how to prevent them. Some physicians blame the dramatic increase in asthma related deaths to an over-reliance on drugs designed to open obstructed airways. It appears more likely, however, that deaths are due to the delay in administering therapy to relieve the attack.

Tips for parents of asthmatic children

Above all else, learn everything you can about asthma;

Learn what triggers your child's attacks and avoid them as best you can;

Recognize the signs of an oncoming attack and learn to judge its severity;

Provide preventive care so that your child has the least amount of difficulty with his or her asthma;

Teach your child how to care for him or herself.

Summary

Although no cure exists for asthma, excellent treatment is available. We learn more about asthma every year and newer, more effective and safer drugs are always being developed. As a result, most asthmatics live normal, productive lives. Research is continuing and the outlook is bright. For more information about asthma, contact your allergist.

For more medical information, please contact an allergist in your area.

Signs and Symptoms: Fifth disease (erythema infectiosum) is a viral illness caused by parvovirus B19. It begins with a low-grade fever, headache, and mild respiratory symptoms (a stuffy or runny nose). These symptoms pass, and the illness seems to be gone, until a rash appears 6 to 11 days later. The bright red rash typically begins on the face and gives the child a "slapped-cheek" appearance. Several days later, the rash spreads and red blotches extend down to the trunk, arms, and legs. The rash usually spares the palms and soles. As the centers of the blotches begin to clear, the rash takes on a lacy net-like appearance. Older children and adults sometimes complain that the rash itches, but most children with a rash caused by fifth disease do not look sick and have no fever. It may take 1 to 3 weeks for the rash to completely clear, and during that time it may seem to fade or worsen. Certain stimuli seem to reactivate the rash, including sunlight, heat, exercise, and stress. Other symptoms that sometimes occur with fifth disease include swollen glands, red eyes, sore throat, diarrhea, and unusual rashes that look like blisters or bruises. In some cases, especially in adults and older teens, an attack of fifth disease may be followed by joint swelling or pain. The hands, wrists, knees, and ankles are affected most often. Some children with immune deficiency, leukemia, or other blood disorders like sickle cell disease or hemolytic anemia may become significantly ill when they have an infection with parvovirus B19. Parvovirus B19 temporarily suppresses the body's production of red blood cells. Under usual conditions, this wouldn't be noticed. But children who need to have a high production rate of new blood cells (such as those with sickle cell anemia) can become severely anemic if their red blood cell production is slowed by the effects of the virus. These children can become very pale and develop a rapid pulse and abnormally fast breathing. They look sick, have fever and malaise (a generally ill feeling), and are lethargic - but they very rarely have the rash seen in fifth disease. Description: Fifth disease occurs everywhere in the world, especially in children between the ages of 5 and 15. Community outbreaks of fifth disease tend to happen in the late winter and early spring, but there may also be sporadic cases of disease throughout the year. The name "fifth" is historic; this infection was counted among the five classical common infections of childhood. Studies show that between 40% to 60% of adults worldwide have laboratory evidence of a past parvovirus B19 infection, but most of these adults cannot remember having had symptoms of fifth disease. This leads experts to believe that most people with a B19 infection have either very mild symptoms or no symptoms at all. B19 spreads from person to person in fluids from the mouth and throat of someone with a B19 infection, especially via large droplets from coughs and sneezes. In households where a child has fifth disease, another family member catches the infection in 15% to 30% of cases. Classmates of children with fifth disease seem to be at special risk of catching the infection. A pregnant woman who has a B19 infection may pass the virus to her unborn child. In most cases this causes no lasting problems for the baby, but, in rare cases, the fetus may be infected if the mother has the infection during the first trimester. Incubation: The incubation period for fifth disease ranges from 4 to 28 days, with the average being 16 to 17 days. Duration: The rash of fifth disease usually lasts 1 to 3 weeks. In older children and adults, joint swelling and pain because of fifth disease have lasted from a few months to more than 4 years.

Child Spacing

I am definitely a parent who likes to plan. I usually like to research what the experts say about certain issues, then make an informed decision. There are usually plenty of experts who have strong opinions one way or the other! That's why I was very surprised to come across only a small amount of literature on the issue of child spacing. What I ultimately failed to find was any overwhelming support for one side or the other: close vs. distant.

However, what I did find was plenty of advice from seasoned parents, the real experts!

Below are some arguments for each side of the issue. In my opinion, however, it is most important to incorporate these beliefs into your own life. Take into consideration what type of child or children you have and how their personality(ies) will adapt to a new baby around. Also consider what kind of person you and your spouse or partner are, whether you consider yourself to have a lot of external support or not, and what your decision will mean not only in the next 2 or 3 years, but in the long term as well. One thing that you cannot predict is the temperament and personality of that next baby. If you had an "easy" first child(ren), be careful not to set yourself up with the expectation that the next one will be so easy. Every child has a different way of interacting with the world and it often happens that just when you thought parenting was a piece of cake because you just had the sweetest angel of a first child -- SURPRISE! Along comes number 2. It could also go the other way: a challenging first child and an easy-going second. Or, if you're really lucky, a few challenging children and not a single one of those peaceful babies you hear your friends bragging about!

Bearing all of that in mind, here are some other things to consider, from all of the different types of "experts":

Points in Support of Close Spacing (less than 3 years)

They will be closer and better friends as they grow up

They will both be launched into school at nearly the same time, which makes for easier transitions on the parents

You won't have to start another in diapers just when you've potty trained the last one

The parents may be older and don't wish to delay pregnancies any longer, for whatever reason

Hand-me-downs don't have to be boxed up because they go directly to the next child!

The first child does not have as much time to become disillusioned that he/she will be the only child forever, thus possibly making his/her adjustment easier

Points in Support of More Distant Spacing (3 or more years)

The older child will be better equipped to take a more active role in caring for themselves (i.e.; tying shoes, dressing, potty, playing)

The older child will be more interested in playing with the new baby, as his ability for more interactive play develops

The older child will have a more mature understanding of the process

The older child can be a role model of sorts, for the younger child to watch and look up to

Sibling rivalry is lessened because the children are at different stages of development and are not as competitive (e.g.; do not share the same interests in toys and activities)

Physically, the mother's body has time to "recover" and stabilize after previous pregnancies and breast-feeding (the standard recommendation is usually 24 months)

From a developmental standpoint, a child who is 3 or 4 years old when a new sibling comes along, is better able to handle the separation and loss of undivided attention from the parent. They have become more independent and have a greater ability to not feel instant abandonment when their needs are not immediately met by the parent(s).

One final word about choosing how to space your children. When speaking to different mothers about this issue, I did receive one overwhelmingly consistent piece of information: Whichever way you decide to go, it will most likely work for you and your family in the end. I have yet to run into someone who regretted their spacing decisions. So, bottom line? Listen to what others have to say, then trust in your own instincts to tell you what will work for you and your children.

August 28, 2000

Top 5 Signs of Potty Training Readiness

How do you know if your toddler is ready to be toilet trained? Here are the top five signs that they may be open to it.

1. Your child watches you with interest while you go to the bathroom. They also imitate other behaviors of yours, such as brushing your teeth, washing hands, etc.

2. Your child can stay dry for at least 2 hours during the daytime. This indicates that he or she is likely going pee-pee all at once, rather than in little spurts throughout the day!

3. Your child can tell you if she's wet or that she wants you to change her diaper.

4. Your child is having predictable bowel movements at relatively the same time(s) each day.

5. Your child can understand directions and is familiar with words like, "potty", "pee-pee", and "poo-poo." It is also beneficial if he can get on and off the potty by himself.

There are many great books on potty training, both for the parent, and for the child. If your familiar with the "What to Expect" series, you may be interested in picking up the book What to Expect When You Use the Potty, by Heidi Murkoff.

Some special considerations when beginning potty training:

- Make sure to implement your potty training plan at a time when there will be very little or no other changes in the home. For example, do not plan an elaborate trip around potty training time. And if you're expecting another little one any time soon, keep in mind that it may not be the best time to toilet train. Either do it beforehand, or, even better, wait until the adjustment to the new baby is made.

- Keep in mind that going to the bathroom is one of the very few things your toddler has control of. Do not put a lot of pressure on them to use the big potty - be patient and let them do it at their own rate. Not only is this respectful to the natural developmental process of a child, it will save you frustration down the road in case of a backfire.

Permissiveness or Punishment? Why neither is effective.

One of the most difficult duties as a parent is disciplining. It requires careful thought, practice, and commitment. And, inevitably, we all question ourselves at the end of the day; no matter what discipline decision we've made.

Many disciplining dilemmas require immediate decision-making. Parents often do not have time to confer with each other and make a thoughtful decision about what to do. Therefore, a lot of disciplining techniques are carried out in the heat of the moment.

The easiest mistake to make in impulsive disciplining is to parent at the extremes, to be too permissive or too punitive. There are reasons why neither extreme is effective.

Permissive parenting is when parents give their children an unlimited amount of freedom and control. They set no limits on their behavior and do not allow them to experience any consequences. This style of parenting can come from many things. A parent could be afraid of placing too much control on her child because he will lash back with a huge temper tantrum. Often, a major reason parents are too permissive with their children is because the parent wants to be liked. She wants to be her son's best friend. The thought of her child being mad at her makes her feel like a bad parent - or bad friend.

Punitive parenting is when parents hold and exercise all of the power. The child is given no freedom. The power and authority is imposed on a child, and the child has no say in the situation. It is often inconsistent, arbitrary (i.e.; at the whim of the parent's current mood), and can sometimes lead to emotional or physical abuse. Many parents are overly punitive because they believe the only alternative is permissiveness, and potentially spoiling their child.

One common characteristic of these two techniques of disciplining is that they are easier to administer on impulse. Both techniques provide an immediate cessation to the behavior, even if they provide no long-term positive effect.

Permissiveness allows the parent-child relationship to be ruled by the child. Children are not capable of managing this type and intensity of authority and it will always backfire. They will not learn, through role modeling, appropriate ways of making decisions, problem-solving, handling conflict, and managing their own emotions. What they will learn to think, however, is that the world will always give them what they want if they just manipulate the situation right. This is a sure setup for unhappiness and disappointment.

With punitive parenting, the most ineffective component is that it is usually impulsive and based on the parent's anger and his/her need to feel retribution. It has no effect on actually teaching, or disciplining, the child. Children may comply with the punishment, but they will not learn from it. Young children are simply not capable of seeing the "bigger" lesson that is trying to be communicated. Punitive parenting also puts the responsibility entirely in the parents' hands. As with permissive parenting where the responsibility is in the child's hands, the child does not learn how to be responsible, handle problems and conflicts, or manage their emotions. Therefore, the parent ultimately must continue punishing the child. The child will never just suddenly appreciate the reasoning behind the punishment. What these children learn is to behave based on the likely punishment. They will not act out of moral understanding, but of fear of punishment. This level of moral reasoning is very immature and must be overcome in order to function in this or any society.

So, where is the middle ground? Where is that "balance" point? Practical, useful, proactive discipline. That's the middle ground.

With proactive discipline, we teach our children how to take responsibility for their actions, without punishing them and without giving in to them. It is not about power or who's in charge, it is about role modeling and taking action. It is not concerned with past mistakes and holding grudges. It's not about yelling or spanking. It requires a tremendous amount of energy and discussion up front. Parents must make sure they are on the same page and are being incredibly consistent in their disciplining. There are boundaries set and rules to be followed, but they are predictable and consistent and children experience natural and logical consequences for breaking them. Children also receive praise for not breaking the rules. There is a strong emphasis on supporting and reinforcing desired behavior as opposed to focusing (thus, reinforcing) negative behaviors.

Proactive disciplining is undoubtedly the harder technique to implement. Nobody ever said parenting was supposed to be easy - if it's too easy, you may need to rethink your techniques! The long term positive effects of proactive parenting are tremendous and rewarding - for you and your child. Your kid will thank you for them later (don't count on them thanking you now!)

Daily Dose of Dr. Greene

A Sucker Born Every Minute.

We've known now for several years that stopping the pacifier can reduce ear infections in children. A new study published in the September 2000 issue of Pediatrics looked at the effect of simply having nurses give a leaflet to parents about the side effects of pacifier use and also instructing them to limit the pacifier to the moments the child was falling asleep (and stopping it entirely at about 10 months of age). The results? Continuous pacifier use decreased by more than 20% and ear infections dropped by almost 30% at the clinics where this education took place. I hope you will consider Daily Dose a leaflet:^) How much better to prevent ear infections than to treat them with round after round of antibiotics!

Do pacifiers cause ear infections?

University researchers from Finland have recently published a study of 845 children attending day care. They followed the children for fifteen months, keeping track of behaviors which might influence the number of ear infections. These included breast feeding, parental smoking, thumb sucking, bottle use, and social class.

The strongest association was with pacifier use, which increased the frequency of ear infections by 50%. In children less than two years of age, pacifier use increased the average number of annual ear infections from 3.6 to 5.4 episodes. In children between two and three years of age, pacifier use increased the number from 1.9 to 2.7 ear infections per year. Presumably, either the sucking motion associated with pacifier use hinders proper eustachian tube function (which normally keeps the middle ear open and clean), or - particularly in day care - the pacifiers act as fomites (germ covered objects that spread infection). The authors suggest that pacifiers be used only during the first ten months of life when the need for sucking is strongest and episodes of ear infections are relatively uncommon.

I believe that sucking is an important comfort measure for many babies. Moreover, sucking objects of various types have been used by most cultures throughout history. In my opinion, this study suggests two take home lessons:

1) If your child is plagued by frequent ear infections, stopping the use of a pacifier is worth a try - certainly before prophylactic antibiotics or surgery.

2) For any child, it is prudent to wean the pacifier as soon as it is no longer something that the child actively needs.

Too often pacifier use persists into middle childhood either out of habit, or because the pacifier has become the child's "lovey" - and not out of any true sucking need. They might just as easily have found comfort from something else.

If this is the case for your child, here are some tips that will help you wean him or her from pacifier use in a constructive way. First, restrict pacifier use to sleep time and stressful situations (getting shots), since most children will become less attached as they experience more of the day without the pacifier. Then, make the pacifiers less attractive while at the same time introducing a new comfort object. To make the pacifiers less attractive, you might put on one drop of 'bitter apple' (found in pet stores), giving the pacifier a mildly unpleasant taste. Combination teddy bear-blankets, such as those made by Dakin, make a nice comforting alternative. For older children, you might try gathering up all the pacifiers and taking them to the toy store for the child to trade in for the toy of their choice. For most kids it will be easier to deal with the pacifier issue now rather than waiting until they become more attached and the habit becomes more ingrained.

Information displayed here my not be the views of Wee Care Child care.